2015-02-16T14:41:38-06:00 2014-06-30 481292483 HENJES CONNER & WILLIAMS PC 800 FRANCES BLDG SIOUX CITY IA 51101 990 2013-07-01 421411233 SIOUXLAND REGIONAL CANCER CENTER SIOU 7122529418 PO BOX 5017 SIOUX CITY IA 51102 DANIEL K LAUER CHIEF FINANCIAL OFFICER 7122529418 2015-02-13 1 MELISSA J WILLER P00121904 7122773931 2015-02-12 2013 2016-03-07 17:11:31Z DANIEL K LAUER 230 NEBRASKA ST SIOUX CITY IA 51101 15957630 0 X WWW.NYLENCANCERCENER.COM X 1995 IA PROVIDES THE HIGHEST QUALITY, COMPASSIONATE CANCER CARE THROUGH PREVENTION, TREATMENT, AND RESEARCH FOR THE PEOPLE OF SIOUXLAND. 12 12 39 20 0 0 420866 500546 8464134 8742966 414626 464466 836905 895671 10136531 10603649 0 0 0 0 2967277 2603219 0 0 177492 5740516 6125468 8707793 8728687 1428738 1874962 16745158 18110740 6808143 6300069 9937015 11810671 PROVIDES THE HIGHEST QUALITY, COMPASSIONATE CANCER CARE THROUGH PREVENTION, TREATMENT, AND RESEARCH FOR THE PEOPLE OF SIOUXLAND. 0 0 7195118 9672736 PROVIDE DIAGNOSIS, TREATMENT, EDUCATION AND CARE FOR CANCER PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 7195118 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 29 0 39 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 X DAN LAUER 7122529418 230 NEBRASKA STREET PO BOX 5017 SIOUX CITY IA 51101 MILT AVERY VICE CHAIRPERSON 1.00 X X 0 0 0 JAMES FITZPATRICK SECRETARY 1.00 X X 0 0 0 LYNN WOLD TREASURER 1.00 X X 0 0 0 ELLEN KAPLAN CHAIRPERSON 1.00 X X 0 0 0 JIM GOBELL DIRECTOR 0.50 X 0 0 0 DR WAYNE BARNES DIRECTOR 0.50 X 0 0 0 TRACY LARSON DIRECTOR 0.50 X 0 0 0 DR JEFFREY KNERL DIRECTOR 0.50 X 0 0 0 DR CYNTHIA PALS DIRECTOR 0.50 X 0 0 0 HUGH DEPAULIS DIRECTOR 0.50 X 0 0 0 SKIP PERLEY DIRECTOR 0.50 X 0 0 0 CHAD MARKHAM DIRECTOR 0.50 X 0 0 0 KAREN VAN DE STEEG EXECUTIVE DIRECTOR 40.00 X 173358 0 34452 DAN LAUER CHIEF FINANCIAL OFFICER 40.00 X 109283 0 21372 CHARLES MURPHY MD RADIOLOGIST 40.00 X 108207 0 12132 390848 0 67956 4 0 1 0 TRI STATE RADIATION ONCOLOGY 230 NEBRASKA STREET SIOUX CITY IA 51101 CONTRACT PHYSICIAN SERVICES 1075485 VARIAN MEDICAL SYSTEMS 3100 HANSEN WAY PALO ALTO CA 94304 EQUIPMENT MAINTENANCE AND RADIATION EQUI 553936 PYRAMID TECHNOLOGIES 125 6TH ST SIOUX CITY IA 51103 CONTRACT COMPUTER SERVICES, SUPLIES AND 354958 CASSLING 13808 F STREET OMAHA NE 68137 EQUIPMENT MAINTENANCE SERVICES 339511 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 MEDICAL EQUIPMENT 245492 10 500546 7800 500546 PATIENT SERVICE REVENUE 621300 8742966 8742966 8742966 165775 165775 311412 197593 113819 113819 113819 5417539 5116421 2427 301118 -2427 298691 298691 188313 37540 150773 150773 OTHER REVENUE 900099 468847 468847 OTHER INVESTMENT INCOME 900099 162232 162232 631079 10603649 9672736 0 430367 X 496940 158475 338465 1639981 1128589 434241 77151 77717 49939 23607 4171 300392 278263 17948 4181 88189 61350 21322 5517 7160 7160 12700 12700 51660 51660 2573992 2445752 94134 34106 2599 2599 104089 48034 46559 9496 1177617 1113623 55702 8292 29928 8661 20964 303 183215 148688 30878 3649 1256324 1162712 70267 23345 MEDICAL SUPPLIES 341629 341629 PATIENT PROGRAM SERVICE 224249 224249 MISCELLANEOUS 160306 25154 130470 4682 8728687 7195118 1356077 177492 2538561 5411199 20264 98036 1408185 1509096 302467 301976 18027316 12685273 6231224 5342043 6224954 5442654 19503 5736 16745158 18110740 1478143 1425069 4875000 4875000 455000 0 6808143 6300069 X 9641780 11164112 295235 646559 9937015 11810671 16745158 18110740 X 1874962 25259 -26565 X X 0 1 X 1 0 X 340588 372101 543839 420866 500545 2177939 8196967 8924064 8495507 8464134 8742966 42823638 8537555 9296165 9039346 8885000 9243511 45001577 100000 100000 100000 177500 477500 0 100000 100000 100000 177500 477500 44524077 73818 87898 103103 148047 165775 578641 73818 87898 103103 148047 165775 578641 383128 545715 470993 434587 468847 2303270 8994501 9929778 9613442 9467634 9878133 47883488 0.92980 0.92950 0.01210 0.01100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 200850 200850 6317956 4216475 2101481 266946 243867 23079 11188614 8224931 2963683 52950 52950 5342043 MUTUAL FUNDS 2523778 F US GOVERNMENT SECURITIES 1514090 F CORPORATE SECURITIES/EQUITIES 1158867 F CERTIFICATES OF DEPOSIT 245919 F 5442654 X 10774841 25259 197593 222852 10551989 51660 51660 10603649 8874620 197593 197593 8677027 51660 51660 8728687 PART X, LINE 2: HEALTH, INC. AND ITS SUBSIDIARIES ARE NON-PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, INCOME EARNED IN THE PERFORMANCE OF ITS EXEMPT PURPOSE IS NOT SUBJECT TO INCOME TAX AND ACCORDINGLY, THE FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. MANAGEMENT HAS CONCLUDED THAT ANY UNCERTAIN TAX POSITIONS WOULD BE IMMATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT INCLUDE ANY PROVISION FOR UNCERTAIN TAX POSITIONS, AND NO RELATED INTEREST OR PENALTIES HAVE BEEN RECORDED IN THE OPERATING STATEMENT OR ACCRUED IN THE BALANCE SHEET. TAX RETURNS OF THE ENTITY ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE DATE THE RETURNS ARE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 197,593. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 197,593. WINTER BENEFIT 137909 137909 15015 300 7392 RACE FOR HOPE 50404 50404 2600 12233 188313 188313 2600 15015 300 19625 37540 150773 X 1 1 X X X X 0 0 0 0 0 0 0 0 0 KAREN VAN DE STEEG EXECUTIVE DIRECTOR 173358 0 0 0 0 0 0 0 34452 0 207810 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 HALF OF THE BOARD WORKS FOR NORTHWEST IOWA HOSPITAL CORPORATION OR IS ON THE NORTHWEST IOWA HOSPITAL CORPORATION BOARD AND HALF OF THE BOARD WORKS FOR MERCY HEALTH SERVICES OR IS ON THE MERCY HEALTH SERVICES BOARD. FORM 990, PART VI, SECTION A, LINE 6 HEALTH INC., NORTHWEST IOWA HOSPITAL CORPORATION AND SUBSIDIARIES, MERCY HEALTH SERVICES AND SUBSIDIARIES FORM 990, PART VI, SECTION A, LINE 7A HOSPITAL BOARDS HAVE TO APPOINT/ELECT THEIR REPRESENTATIVES. FORM 990, PART VI, SECTION A, LINE 7B TRINITY HEALTH AND IOWA HEALTH SYSTEMS HAVE TO APPROVE LARGE CAPITAL PROJECTS FORM 990, PART VI, SECTION B, LINE 11 ORGANIZATION REVIEWED AND SUBMITTED RETURN UPON COMPLETION BY PREPARER FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A FORM DETAILING ANY AND ALL BUSINESS RELATIONSHIPS WITH HEALTH INC AND RELATED ENTITIES. ALL COMPLETED FORMS ARE REVIEWED AND DISCUSSED WITH THE BOARD AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 TOP MANAGEMENT EMPLOYEES PROVIDE INDEPENDENT DOCUMENTATION FROM TRADE SOURCES TO SUBSTANTIATE PAY LEVELS. FORM 990, PART VI, SECTION C, LINE 19 ALL ITEMS ARE AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,445,752. MANAGEMENT AND GENERAL EXPENSES 94,134. FUNDRAISING EXPENSES 34,106. TOTAL EXPENSES 2,573,992. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT -26,565. FORM 990, PART XI, LINE 2C NO CHANGES HEALTH INC 230 NEBRASKA STREET SIOUX CITY IA 51101 311712115 SERVE AS THE CENTRAL ORGANIZATION FOR OTHER 501(C) (3) ENTITIES IA 501(C)(3) PF 0 SIOUXLAND PARAMEDICS 1701 TERMINAL DRIVE SIOUX CITY IA 51105 421185707 MEDICAL TRANSPORTATION SERVICE IA 501(C)(3) 509(A)(3) TYPE I 0 MERCY HEALTH SERVICES 801 FIFTH STREET SIOUX CITY IA 51102 311019872 PROVIDES A FULL CONTINUUM OF WELLNESS, PRIMARY, ACUTE AND TERTIARY SERVICES IA 501(C)(3) 509(A)(3) TYPE III 0 HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY IA 51101 383320710 PROVIDE COMFORT, SUPPORT, AND COMPASSIONATE CARE TO TERMINALLY ILL PEOPLE AN IA 501(C)(3) 509(A)(3) TYPE I 0 NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY IA 51104 421019872 STRIVES TO PROVIDE THE MOST PATIENT-CENTERED CARE IN SIOUXLAND IA 501(C)(3) 509(A)(3) TYPE III 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 HOSPICE OF SIOUXLAND M 21600 HOSPICE OF SIOUXLAND L 67390 HOSPICE OF SIOUXLAND O 324000 SIOUXLAND PARAMEDICS O 87000 SIOUXLAND PARAMEDICS M 157600 MERCY HEALTH SERVICES E 2437500 NORTHWEST IOWA HOSPITAL CORPORATION E 2437500 MERCY HEALTH SERVICES M 128901 MERCY HEALTH SERVICES L 388355 NORTHWEST IOWA HOSPITAL CORPORATION M 60045 NORTHWEST IOWA HOSPITAL CORPORATION L 135303